WHAT needs to happen before chief executives of big organisations "fall on their swords" and accept responsibility for appalling performance?

Selby and York Primary Care Trust has been reduced to a humiliating one star in the latest health care commission ratings - one of the worst results in North Yorkshire. The PCT faces a huge financial deficit of £25 million and rising.

As usual, the mantra from senior health managers is: "We can work things out and patient care won't be affected." If that is true, has the PCT been sitting on the potential to make millions in savings over recent years, but not bothered to take action until now? Inevitably, the next act in this farce will be that local NHS jobs will go and care facilities will close down, all, naturally, "without affecting patient care". It is time for heads to roll!

John Gallagher,

Oaken Grove,

Haxby, York.

Updated: 09:35 Monday, August 01, 2005